Preventable medication errors are common in children. The overall goal of this Pediatric Medication Safety proposal is to advance our knowledge of pediatric medication errors by identifying which medications and which children are associated with high harm and near harm medication errors among high healthcare burden pediatric conditions, as well as systematically explore the causes of these errors. These analyses will serve as a tool to identify areas and medications in need of targeted interventions for reducing errors. This goal will be accomplished by systematically examining nationally representative data on pediatric medication errors from MEDMARX data. MEDMARX is an Internet-accessible, subscription-based, voluntary medication error reporting program. Each error report is standardized and captures information regarding the error's timing, unit location, inpatient versus outpatient location, phase of error, error category, cause of error, medication involved, error type, error factors and information on the facility where the error occurred. MEDMARX is in use in 590 facilities representing all 50 States in 2005, receives over 20,000 medication error reports per month, and currently contains almost one million reports. Given our previous work on synthesizing literature on pediatric medication errors and identifying high healthcare burden pediatric conditions, we will stratify data into strategic focus areas. These focus areas will include: all ambulatory settings, hospitalized infants, children with heart disease, children with oncologic conditions, and psychiatric medications including those for Attention Deficit Hyperactivity Disorder. These focus areas all represent high burden pediatric conditions for which little is known about the types and causes of medication errors that occur. These areas are ripe for targeted medication safety solutions. The Specific Aims of the project are: Specific Aim #1: for high healthcare burden pediatric conditions, examine which types of medications and which children are associated with reported harmful and near-harmful medication errors; and Specific Aim #2: for high healthcare burden pediatric conditions, examine whether the causes of 'no harm' medication errors are the same as those errors that are harmful. Analysis for each of the Specific Aims will take the MEDMARX variables and perform Chi-Square, ANOVA tests, and logistic regression to identify associations and trends. In addition, qualitative synthesis of error causes and contributing factors will also be performed. The products of this project will be directly useful in developing targeted solutions and policies to prevent harm to children from medication errors. [unreadable] [unreadable] [unreadable]